ARSD 67:16:44:07. Payment limitations

Payments at an all-inclusive rate to a federally qualified health center or rural health clinic are subject to the following limitations: (1) Encounters with more than one health professional and multiple encounters with the same health professional, which take place on the same day, constitute a single visit, unless the visit meets the criteria stated in subdivision (2) of this section; (2) Payment is limited to two visits a day. The second visit is payable only if, after the first visit, the patient suffers illness or injury that requires additional diagnosis or treatment, one of the visits is for behavioral health services covered under chapters 67:16:41 or 67:16:48, or one of the visits is for dental services provided under chapter 67:16:06; and (3) Payment is limited to those covered services provided by a physician, physician assistant, nurse practitioner, visiting nurse, mental health provider listed in § 67:16:41:03, dentist, or an accredited substance use disorder provider.